You may have a special blood test during surgery that will tell if all the diseased glands were removed. In rare cases, when all four of these glands need to be removed, part of one is transplanted into the forearm. Or, it is transplanted into a muscle in the front of your neck next to the thyroid gland.
Surgery of the Thyroid and Parathyroid Glands
This helps ensure your body's calcium level stays at a healthy level. Types of surgery include: Minimally invasive parathyroidectomy. You may receive a shot of a very small amount of radioactive tracer before this surgery. This helps highlight the diseased glands. If you have this shot, your surgeon will use a special probe, like a Geiger counter, to locate the parathyroid gland.
Diagnosis of Thyroid and Parathyroid Conditions
Your surgeon will make a small cut 1 to 2 inches; or 2. This procedure takes about 1 hour. Video-assisted parathyroidectomy.
Your surgeon will make two small cuts in your neck. One is for instruments, and the other is for a camera. Your surgeon will use the camera to view the area and will remove the diseased glands with the instruments. Endoscopic parathyroidectomy. Your surgeon will make two or three small cuts in the front of your neck and one cut above the top of your collarbone.
This reduces visible scarring, pain, and recovery time. This cut is less than 2 inches 5 cm long. The procedure to remove any diseased parathyroid glands is similar to video-assisted parathyroidectomy. Why the Procedure is Performed. Some of these factors are: Your age Calcium levels in your urine and blood Whether you have symptoms.
Parathyroid Gland Introduction
Risks for anesthesia and surgery in general are: Reactions to medicines or breathing problems Bleeding , blood clots , or infection Risks for parathyroidectomy are: Injury to the thyroid gland or the need to remove part of the thyroid gland. This can lead to low calcium levels that are dangerous to your health.
Injury to the nerves going to the muscles that move your vocal cords. You may have a hoarse or weaker voice which could be temporary or permanent. Difficulty breathing. This is very rare and almost always goes away several weeks or months after surgery. Before the Procedure.
Tell your surgeon: If you are or might be pregnant What medicines, vitamins, herbs, and other supplements you're taking, even ones you bought without a prescription During the week before your surgery: Fill any prescriptions for pain medicine and calcium you'll need after surgery. The pituitary and thyroid glands work together to produce the right amount of thyroid hormone for the body. If too little thyroid hormone is produced, people are considered hypothyroid; if thyroid hormone is produced in excess, they are diagnosed as hyperthyroid.
The opposite problem, hypoparathyroidism, occurs when parathyroid glands do not produce enough PTH, leading to low blood calcium levels and adversely affecting muscles, nerves and other functions. Our specialists diagnose thyroid and parathyroid disorders through comprehensive testing that starts with a complete history and physical exam, and is followed by blood work, an important step in identifying the disorder.
Depending on the specific problem, we may conduct an ultrasound of the neck to identify abnormalities. Ultrasounds also allow us to guide a needle biopsy, if necessary, to evaluate nodules or lymph nodes in the neck. At the University of Michigan, each patient is carefully evaluated by our team of experts so the best decision can be made on the most appropriate course of treatment.
Deciding which treatment is best for each patient depends on the cause and severity of the disease, as well as a number of other factors. Thyroid and Parathyroid Disorders - Otolaryngology. About Thyroid and Parathyroid Disorders Thyroid disorders typically occur when the thyroid gland a small, butterfly-shaped gland located in the lower portion of the neck releases too many or too few hormones. Diagnosis of Thyroid and Parathyroid Disorders Our specialists diagnose thyroid and parathyroid disorders through comprehensive testing that starts with a complete history and physical exam, and is followed by blood work, an important step in identifying the disorder.
Treatment for Thyroid and Parathyroid Disorders At the University of Michigan, each patient is carefully evaluated by our team of experts so the best decision can be made on the most appropriate course of treatment.
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We see patients with a wide range of thyroid disorders, including: Thyroid nodules are growths or lumps in the thyroid gland. This depends on the time of day that the surgery starts as well as the extent of surgery. More complicated surgery will require a longer period of observation in the hospital before discharge. Anesthesia The operation is usually performed under general anesthesia medically induced sleep. Some surgeons do the operation with the patient awake and with light sedation and local anesthesia which numbs the area of the body being operated on. The safety of either approach is equal; however, many surgeons prefer to perform the procedure under general anesthesia for several reasons:.
Incisions The usual incision is placed in the midline of the lower neck and parallel to the natural horizontal tension skin lines or creases when present.
In young patients the incision is situated low in the neck at the level of a shirt collar, above the level of the clavicles. The length of the incision depends on the size of the thyroid gland that needs to be removed. Usually it is no more than the size of the area between the two large muscles sternocleidomastoid that run up and down the neck. Some incisions can be as small as one inch.
The Center For Thyroid & Parathyroid Surgery | New York Head & Neck Institute
However, the key to an inconspicuous scar, regardless of its length, is the use of delicate soft tissue handling techniques and meticulous wound edge approximation. Longer incisions are needed for safe exposure of the surgical field, especially if the patient has a large goiter. Attempting to squeeze a large thyroid gland through a very small incision can cause excessive trauma to the wound skin edges and this may lead to poor healing and adverse scaring. If there is a prior scar from previous thyroid surgery that site will usually be used for the incision by removing the old scar.
In young patients who heal quickly, scars generally are more elevated and red in the first six to eight months of healing but eventually flatten and lighten. Certain topical agents including fresh aloe vera gel and dimethicone silicone gel may be of benefit for the first 8 weeks of healing.
Your surgeon will discuss methods of wound care to achieve the best possible scar. It is important to avoid direct sun exposure for the first year to prevent darkening of the scar. This prevents the accumulation of blood and fluid under the skin and reduces the need to drain this collection in the office. Stitches sutures Most stitches are placed under the skin level and dissolve on their own.
You can bathe with the strips on the skin after the initial bandage has been removed. Risks and Complications In skilled hands, there are several rare potential risks of thyroid surgery. However, a brief period of hoarseness or difficulty singing with pitch control, early voice fatigue and difficulty projecting the voice may occur from either minor swelling of the vocal folds themselves, trauma to the muscles that raise or lower the larynx voice box or from a weak or immobile vocal fold paralysis. Some surgeons will use a nerve monitoring system during the surgery when performed under general anesthesia to alert of inadvertent stretch or other injury to the laryngeal nerves.
However, nerve monitoring has not been proven to reduce the incidence of vocal fold palsies, especially in the hands of expert surgeons. Vocal fold mobility is usually documented both prior to and after thyroid and parathyroid surgery using a thin flexible telescope for viewing the larynx.
The majority of patients with voice impairment improve without treatment. Parathyroid Gland injury and Hypocalcemia Depending on the extent of surgery and number of bruised or autotransplanted parathyroid glands, temporary hypoparathyroidism under-production of parathyroid hormone can occur and blood calcium levels may drop below the normal range.